| NPI | 1710443593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JOHN CROSS Clinic Director 641-787-0067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-02-16 |
| Last Update Date | 2019-09-06 |